Despite advances in detection and treatment, depression continues to take a toll on working individuals, their families, and their employers. This project's long-term goal is to provide effective and efficient work focused care that will help employees with depression function more effectively and productively. This project will further develop and test a new multi-modal, work-focused intervention to be provided by Employee Assistance Program (EAP) counselors whom companies already employ. Named the Work and Health Initiative (WHI), it will provide: 1) depression screening; 2) activities to improve coordination of care between the employee, the primary care physician, and the workplace; 3) work-focused cognitive behavioral therapy (CBT) strategies; and 4) work modifications. Aim 1 is to address questions related to the feasibility and acceptability of the WHI. Guided by a set of research questions, this project will first investigate the feasibility of implementing the WHI in the workplace, and its acceptability to employees, EAP counselors, and primary care providers. These questions will be investigated in focus groups with WHI stakeholders, and trial runs of the WHI. Qualitative and quantitative data will be collected. An expert panel will analyze the data in order to identify strengths and weaknesses of the WHI, and produce recommendations for improvement. Changes will be implemented prior to Aim 2. Aim 2 is to conduct a pilot- randomized control trial (RCT) of the WHI. Employees of state government in Maine (n=13,000) will be eligible to be complete a private, web-based depression and work performance screening. Employees with depression having work performance problems will be identified and invited to visit the EAR. Following an in-person interview and consent, half will be randomly assigned to the usual care group, and half will be assigned to the experimental WHI group (total n=175). Subjects will be surveyed at baseline and four months later. The primary outcomes will be employee work performance and productivity, using the validated Work Limitations Questionnaire (WLQ), and its work absence module. An intent-to-treat analysis will quantify the new program's impact on employee work performance and productivity, depression symptoms, and satisfaction with care. This project will provide valuable insights into the feasibility, acceptability and impact of the WHI. Results will also indicate whether further effectiveness testing and translational research are warranted.